Provider Demographics
NPI:1891924981
Name:STOUT, ADAM LEONARD (DMD)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:LEONARD
Last Name:STOUT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 LATIGO DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89002-3650
Mailing Address - Country:US
Mailing Address - Phone:928-460-2654
Mailing Address - Fax:928-460-2654
Practice Address - Street 1:7120 SMOKE RANCH RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-3157
Practice Address - Country:US
Practice Address - Phone:702-798-8409
Practice Address - Fax:702-798-7203
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVS7-1121223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics